Ironically, it was the increase in sanitary living conditions that provided a way for polio to devastate communities. Prior to the improved sanitation in wealthier countries, babies were exposed to polio while still protected by their moms’ antibodies. This allowed them to fight off infection and develop immunity.

However, during this time when we were cleaning up our act, but before we had vaccines to protect us against polio, the older kids and adults who’d lost their moms’ antibodies were unprotected and were vulnerable targets for the poliovirus.

Polio vaccines were introduced in the U.S. in the ‘50s and ‘60s, halting the episodic surges of infection experienced in this country.

My teenager was vaccinated against polio when the oral vaccine was still being used in this country. I remember warnings from her pediatrician about the need to be careful during diaper changes and to always wash my hands afterward.

I hesitated when she told me about the polio vaccine she wanted to give my daughter. Polio was not a common infection in the world in the 1990s, and I debated if the risk of vaccination was worth it. After all, 144 of the 152 cases of polio in the U.S. between 1980 and 1999 were caused by the live oral polio vaccine, not the wild poliovirus.

In the end, I had her vaccinated because I felt it was the safer choice for her and those around her. When it comes to eradication of a disease, we don’t stop vaccinating when it’s mostly gone. We keep vaccinating until it’s long gone.

Fast-forward a couple of centuries to the 1950s, when Dr. Jonas Salk developed the first polio vaccine and right on his heels was Dr. Albert Sabin, with another vaccine that became widely used. Cases of polio plummeted in most countries, but each year there were still hundreds of thousands of kids infected.

Fresh from the success of smallpox eradication, an opportunity to do the same to polio was envisioned and energies were renewed in 1988, when the World Health Assembly launched the Global Polio Eradication Initiative.

Twenty years later, the World Health Organization reports on the success of the Initiative:

“Polio cases have decreased by over 99% since 1988, from an estimated 350,000 cases in more than 125 endemic countries then, to 1604 reported cases in 2009 . . .”

That’s pretty good. But, polio keeps flaring up. Areas and countries that were once polio-free have seen the virus imported by those not protected through vaccination. In 2009-2010, 23 countries saw such activity. Seems we’re moving in the wrong direction.

Why are we still reading about polio? This virus (of which there are three types) won’t go away which is a tragedy when there are good vaccines to prevent infection.

The current status info from the CDC reads like this:

Since 1988, when the Global Polio Eradication Initiative was established, the incidence of polio has decreased from an estimated 350,000 cases annually to 1,655 reported in 2008.

Cases of wild poliovirus (WPV) type 2 were last reported in October 1999, and indigenous WPV types 1 and 3 (WPV1 and WPV3) have been eliminated from all but four countries worldwide (Afghanistan, India, Nigeria, and Pakistan).

This month, a report on PBS discussed the rumors spread in northern Nigeria a few years ago. The word on the street was that the polio vaccination campaign was a U.S.-led conspiracy against Muslims. Rather than protecting children, the vaccine supposedly made the little ones infertile. As these rumors spread, several regional governments in northern Nigeria suspended the vaccination program – some for as long as 13 months.

After the CDC and others spent months working with leaders in the area, explaining where the vaccine comes from and its safety, the people started to come around. Now, in Nigeria, the vaccination campaign is back, yet cases of polio in Nigeria and elsewhere continue to ebb and flow.

So, why are we still reading about polio?

Not everyone is getting vaccinated.

Symptoms are slow to appear after initial infection, making it harder to get a jump on the virus when it first appears.

In poorer countries, the public health infrastructure is weak, making it difficult to educate the population about the disease and prevention methods.

Vaccine delivery and administration is affected by the lack of government support.

Those administering the vaccines are sometimes improperly trained and/or submit false reports with inflated numbers of people receiving vaccinations.

Where’s the end? No one seems to know. Polio should be history, but instead, it continues to be the nightly news.

Disclaimer

The information on PKIDs' Blog is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for you or your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.